How a shoe fits your child’s foot is quite important for providing proper stability, protecting the foot, and helping to prevent injury. Unfortunately, there are few resources available to educate parents about how to determine not only if a shoe is appropriate for a child, but also if the shoe is fitting properly. Taking the time to examine shoes properly, ensure that the shoe fits, and to be aware of the life span of shoes can help your child’s lower extremity health.

Some key points to remember about shoe gear:

1. There is no "Universal Standard" for shoe gear size, both in width and length. Due to this fact, it is difficult to buy shoes solely according to shoe size. How the shoe feels on the foot and fits on the foot is more important.
2. More expensive is not necessarily better. Depending on the money that a shoe company may spend on factors (marketing) other than the materials and the methods used to create a shoe, the quality of a shoe may suffer.
3. There is no such thing as a "break-in period" for shoes- if the shoe feels too tight, it is too tight- after your foot stretches the material (which is what most people assume to be the "break-in period"), the shoe is actually less supportive. Take a look at some dress shoes that women wear- the upper of the shoe is actually expanded out over the platform on the sole and you can see the outline of the toes on the upper of the shoe- henceforth, the upper is trying to make up for lack of a sole under the foot.
4. Shoe gear has laces for a reason- to be tied so that the foot is supported from the sides as well as the bottom. Fashion trends tend to cycle and every so often the latest fad is to leave the shoes untied- this can lead to falls, twists, sprains and possibly fractures of the feet and/or ankles.

What to look for in a stable shoe:

• The heel counter should be rigid- if you grasp the heel counter of the shoe between your index finger and thumb just above the sole and squeeze, you should not be able to completely collapse the counter.

• If you hold the shoe in both hands and attempt to bend the shoe from the front, it should bend at the area of the toes. If the shoe bends more in the middle, then it has poor flexion stability, and will provide poor support in the arch as a person is rolling toward the ball of the foot and rolling off of the toes.

• Torsion Stability is another excellent test- if you grasp the front of the shoe, then hold the shoe at the back and attempt to twist it, you should not be able to torque the shoe very much- if you can completely fold the shoe in half lengthwise, there is little chance of supporting the foot properly, particularly if your child has a pronated foot (a tendency for the arch height to collapse and the foot roll inward).

• Take your child shoe shopping in the evening. The feet naturally swell during the course of the day. This will ensure a proper fit.
• If your child is going to have his or her feet measured by a staff member at the shoe store, this measurement NEEDS to be taken standing- the foot can elongate and certainly widens as a person puts weight on the foot. Also, use the measurement as a GENERAL GUIDLINE- recall that there is no universal standard for shoe gear size.
• Perform all of the stability testing as outlined above.
• After the shoe passes the stability testing, have your child try the shoe on.

• Check to see that the width of the shoe is adequate- if it appears as though the foot is pushing the upper of the shoe out over the platform of the sole, the shoe is too narrow. At the same time, do not neglect the width and fit at the heel of the shoe. Although there should be adequate room at the front of the shoe, a compromise must be made so that your child’s heel does not slip out of the shoe or slip around inside of the shoe.

• There also should be approximately ½ inch(about the width of a thumb) between the tip of the longest toe(IT’S NOT ALWAYS THE BIG TOE, IN SOME PEOPLE IT IS THE 2^ND TOE) and the front of the shoe.

• After determining that the shoe is stable and fit is proper, have your child walk around in the shoes for 5-10 minutes; a quick walk back and forth for 10 seconds does not relay how the shoe actually feels on the foot. Although this may appear time consuming, it can save time spent in a doctor’s office treating a chronic or acute injury resulting from a poorly fitting shoe or even worse, time away from activity for your child.

• Please ascertain in what types of activity your child is going to be participating , and be sensible about not trying to get one shoe to be an all purpose shoe- if your child plays sports that are at a different spectrum or plays a sport that requires specific shoegear, whether competitive or recreational, he or she may need a shoe that is specific to their sport and another shoe for general wear.

• The most important part of shoe gear that is often overlooked is shoe gear LIFE SPAN. For general shoe wear, the materials in the shoe are worn out after 6 months, no matter what the visual appearance of the shoe. At the chemical/molecular level, the shoe material loses its supportive properties. A good analogy is that of car tires- even if you let a car sit idle for months, the rubber in the tires breaks down and wears out. For athletic shoes, probably one season is the limit; for those athletes who participate in their sport year-round, the shoe gear should be evaluated and most likely replaced every 4 months. For runners, replacing the shoes every 300-400 miles is an excellent interval.

By following these guidelines, your child should run into little problems; however, if he or she is noticing any type of foot or ankle problems, despite using proper shoe gear that is replaced at regular intervals, have him or her examined by a Foot and Ankle Specialist.